The case for individual credentialing

Whether credentialling keeps you up at night or is just in the back of your mind, it’s absolutely crucial for the health of your therapy practice. You’ve probably heard the pitch: get credentialed with insurance panels, and you’ll have a full client roster. But what’s often left unsaid is the why and the how of individual vs. group credentialing, and what that actually means for you. So, let’s explore why it’s worth the effort, even if the process feels tedious. 

What is individual credentialing? 

Individual credentialing means getting approved by insurance companies under your own name. It’s an official stamp confirming that you meet recognized standards, which includes your education, licensure, and professional background. This approval does two big things: it builds trust with clients, who know you’re a qualified expert, and it allows you to accept payments directly from insurers. This process sounds technical, but it’s key to operating as a confident, respected therapist in today’s landscape. 

Beyond the “full schedule” hype 

Yes, being in-network with insurance companies can help you attract more clients. Healthcare is expensive, so people prefer to use their benefits. Joining panels makes you more accessible. But credentialing isn’t just about filling appointment slots. It’s about control, flexibility, and the long-term financial well-being of your practice. 

A quick reality check: being in-network doesn’t magically fill your schedule. You’ll still need to market yourself—think networking, online presence, or community outreach—to bring in clients. Credentialing is just one piece of the puzzle, but it’s a powerful one. 

Group vs. individual: what’s the difference? 

If you work in a group practice, you might have been offered group credentialing. It sounds tempting—less work, right? But before you decide, let’s break down the differences between group and individual credentialing, and why going solo might be the smarter move. 

Group credentialing 

• You’re credentialed under the umbrella of a larger practice or organization. 
• Your reimbursement rates are tied to the group’s negotiated rates (which might be lower than what you could get on your own). 
• Billing is usually handled centrally, meaning you have less control over the process 

Individual credentialing 

• You’re credentialed directly with insurance panels as a solo practitioner. 
• You negotiate your own rates (within the panel’s limits) and manage your own billing and claims. 
• You have more control, flexibility, and independence in how your practice runs. 

Why individual credentialing might be your best bet: 

So, why go through the trouble of credentialing on your own, especially if a group practice offers to handle it for you? Here are the benefits that make it worth your time: 

You call the shots (within reason) 

When you’re credentialed individually, insurance companies pay you directly and communicate with you directly. No middlemen, no back-and-forth with a group’s billing team—just clear, straightforward transactions. This cuts down on delays, reduces administrative headaches, and gives you real-time insight into your claims. 

Plus, you’re not stuck with a group’s reimbursement rates, which might undervalue your services. While insurance panels set fee schedules, there’s often wiggle room to negotiate, especially if you specialize in a niche area or have a strong reputation. Taking charge like this frees up your time. 

Direct relationships 

With individual credentialing, you’re not just a name on a group’s roster; you’re a recognized provider with a direct line to insurance panels. This makes it easier to resolve issues, clarify policies, or advocate for yourself. If a claim gets delayed, you’re not waiting on someone else to fix it. You can take action yourself. 

Freedom to move 

Dreaming of starting your own practice or relocating someday? Individual credentialing travels with you. Unlike group credentialing, which ties you to a specific organization, individual credentialing gives you the freedom to change settings or go solo without starting over from scratch.  

Financial transparency 

When you handle your own billing (or hire a trusted billing service), you get a crystal-clear view of your income and expenses. You’ll know exactly what’s being billed, how much you’re earning, and where your money is going. This transparency helps you make smarter financial decisions for your practice. 

Building your brand 

Individual credentialing reinforces your professional identity. Being recognized as an independent provider by insurance panels sets you apart from the crowd. It makes it easier for referring professionals, community partners, and potential clients to find you. Over time, this visibility can open doors to new opportunities, like contracts or partnerships, that might not be available under a group’s umbrella. 

Faster reimbursement 

Fewer hands on your claims means faster payments. When you’re individually credentialed, there’s no group practice slowing down the process—your reimbursements go straight to you, often in less time. 

The challenges (because it’s not all sunshine and roses): 

Let’s be real: individual credentialing takes work. It involves paperwork, follow-up, and understanding the nuances of each insurance panel’s requirements. It’s an investment of time and effort. 

It can also be a bit daunting at first. There’s a learning curve involved in navigating the application process and understanding the billing codes and procedures. 

Despite the effort, the long-term benefits often outweigh the initial hurdles. 

How to get started with individual credentialing: 

• Research: Start by identifying the insurance panels most relevant to your clients and location. Focus on the ones your ideal clients are likely to use. 
• Organize: Gather all your documents—licenses, certifications, malpractice insurance, and anything else insurers might request. Having everything in one place will save you time and stress. 
• Submit accurate applications: Fill out applications with precision. Double-check for errors, as mistakes can lead to delays. If an insurer asks for more information, respond quickly to keep things moving. 
• Stay on top of it: Track your application status and don’t hesitate to follow up with insurance representatives. Persistence is key, as the process can take weeks or even months. 
• Consider help: If the process feels overwhelming, consider working with a credentialing service. While this involves a cost, it can save you a significant amount of time and hassle. Choose wisely, though, and make sure the service understands your specific needs. 
• Update and maintain: After approval, keep your records fresh. Whenever you renew your license or earn additional training, make sure your profiles reflect it. 

Invest in your future 

Individual credentialing is more than just paperwork—it’s an investment in your career. It establishes you as a trusted, independent therapist, helps you reach more clients, and puts you in control of your practice. Faster payments, clearer finances, and greater flexibility mean less stress and more time to focus on what you love: making a difference in people’s lives. 

Yes, the process takes effort, but it’s worth it. By taking this step, you’re building a strong foundation for your practice—today and for years to come.